Phone: 219.926.3233

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Volunteer Application

Rebuilding Together Duneland
Post Office Box 644
Chesterton, IN 46304

Phone: 219.926.3233

APPLICATIONS DUE: April 10th
WORK DAY: April 28, 2012

Online Volunteer Application

To send an email, just fill in the fields below and click "Send Mail". Please include your valid e-mail address to receive a response.

Contact Information
* indicates required fields
First Name *
Last Name *
Home Phone *
Cell Phone *
E-mail Address *
Address
City
State
Zip/Postal Code
Shirt Size
Group or person you'd like to work with
Please check the following that apply:

Unskilled Labor

Ambassador

House Captain

GO-FOR
(must have valid driver's license and truck or van)
 

Skilled Labor (please specify below)

Carpentry

Concrete

Drywall

Electric

Heating/AC

Landscaping

Masonary

Plumbing

Roofing

Other

Allergies (If yes specify)
Vegetarian

Yes

No

NOTE:

Look for your registration postcard one week prior to workday confirming your work site and schedule. Registration is in the Chesterton Middle School cafeteria on Saturday, April 28, 2012 at 7:30 am with complimentary breakfast.

The information that follows will require an actual signature before your shift.
RTD VOLUNTEER WAIVER OF LIABILITY (Both Adults and Minors must sign here)
In consideration of the opportunity afforded me to assist on a voluntary basis in the Rebuilding Together Duneland Area Home Repair Project, a project in which homes of disadvantaged persons will be repaired by volunteers, and in light of the aims and purposes of the community service provided by Rebuilding Together, Inc. in organizing this project, I hereby waive any right or cause of action arising as a result of my participation in said project from which any liability may or could accrue against Rebuilding Together, Inc. or Its officers and directors collectively or individually. Without limiting the generality of the foregoing, I agree that this waiver shall include any rights or causes of action resulting from personal injury to me or damage to my property sustained in connection with my activities for the Home Repair Project.
Enter Your Full Name *

If you are under of the age of 17, you must have consent from a parent/guardian.

RTD PARENTAL PERMISSION (Ages 14- 17)
In consideration of the opportunity afforded my child to assist on a voluntary basis in the Rebuilding Together Duneland Home Repair Project, a project in which the homes of disadvantaged persons will be repaired by volunteers, and in light of the aims and purposes of the community service provided by Rebuilding Together Duneland in organizing this project, I (we) give my (our) permission for my (our) child to participate in the Home Repair Project, and I (we), on behalf of my (our) child and myself (ourselves), waive any right or cause of action arising as a result of my(our) child's participation in said project from which any liability may or could accrue against Rebuilding Together or its officers and directors collectively or individually. Without limiting the generality of the foregoing, I (we) on behalf of my (our) child and myself (ourselves), agree that this waiver shall include any rights or causes of action resulting from personal injury to my (our) child or damage to my (our) child's property sustained in connection with my (our) child's activities from the Home Repair Project.
Enter Parent Full Name * Over 17 - Enter SELF
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Rebuilding Together Duneland Volunteer